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Fetal Heart Tracing

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162. Clinical Guidelines and Standardization of Practice to Improve Outcomes

SR, Breizat AH, Dellinger EP, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. Safe Surgery Saves Lives Study Group. N Engl J Med 2009; 360:491–9. 10. Cabana MD, Rand CS, Powe NR, Wu AW, Wilson MH, Abboud PA, et al. Why don’t physicians follow clinical practice guidelines? A framework for improvement. JAMA 1999;282:1458–65. 11. Clark SL, Nageotte MP, Garite TJ, Freeman RK, Miller DA, Simpson KR, et al. Intrapartum management of category II fetal heart (...) rate tracings: towards standardization of care. Am J Obstet Gynecol 2013;209:89–97. 12. American College of Obstetricians and Gynecologists. Quality and safety in women’s health care. 2nd ed. Wash- ington, DC: American College of Obstetricians and Gyne- cologists; 2010. 13. Clark SL, Meyers JA, Frye DK, Perlin JA. Patient safety in obstetrics–the Hospital Corporation of America experi- ence. Am J Obstet Gynecol. 2001;204:283–7. 14. Weinberger SE, Lawrence HC, Henley DE, Alden ER, Hoyt

2019 American College of Obstetricians and Gynecologists

163. British Association for Sexual Health and HIV national guideline for the management of vulvovaginal candidiasis

is advisable before prescribing two or more drugs associated with QT prolongation (increasing age, female sex, cardiac disease, and some metabolic disturbances (notably hypokalaemia) predispose to QT prolongation) o Co-administration of medicinal products known to prolong the QT interval and which are metabolised via the cytochrome P450 (CYP) 3A4 such as cisapride, astemizole, pimozide, quinidine and erythromycin are contraindicated in patients receiving fluconazole. Severe Vulvovaginal Candidiasis (...) in 4 pregnant women was significantly associated with shorter anogenital distance suggesting a potential anti-androgenic effect. 117 • It is important to note that exposure to standard dose fluconazole at any stage in pregnancy would not usually be regarded as medical grounds for termination of pregnancy or any additional foetal monitoring. 118 VVC and pregnancy outcome: • Previous studies did not find evidence of an association between Candida colonisation and premature delivery or low birth

2019 British Association for Sexual Health and HIV

164. Guidelines for crises in anaesthesia - Quick Reference Handbook

IS THE PREFERRED TECHNIQUE • Unexplained dyspnoea/tachypnoea and agitation if conscious • At least one of ‘Beck’s Triad’: o Jugular venous distension o Muffled heart sounds o Hypotension • Other signs: Pulsus paradoxus; ECG ? low voltage QRS / electrical alternans / pulseless electrical activity; chest X-ray ? enlarged cardiac silhouette Box B: EMERGENCY PERICARDIOCENTESIS (sub-xiphoid approach) ULTRASOUND GUIDANCE IS THE PREFERRED TECHNIQUE WARNING: Myocardial rupture, aortic dissection and severe bleeding (...) , phenytoin or a barbiturate can also be used. Box C: CRITICAL CHANGES Cardiac arrest ? 2-1 START. ? Prepare the cardiac arrest trolley for any further events. ? Use positive pressure ventilation, aiming for: • SpO 2 > 94% and 4.5 kPa and 100 mmHg. ? Obtain 12-lead ECG and discuss with cardiology if percutaneous coronary intervention is possible or appropriate. ? Check blood glucose. Start glycaemic control therapies if above 10 mmol.l -1 . ? Check core temperature. Target temperature is a constant

2019 Association of Anaesthetists of GB and Ireland

166. Evaluation and management of polyhydramnios Full Text available with Trip Pro

, micrognathia, abnormalities that compress the trachea (neck, mediastinal, or lung masses, congenital high airway obstruction sequence, diaphragmatic hernia), gastrointestinal tract obstruction, and neurologic or muscular disorders such as myotonic dystrophy. Fetal abnormalities that cause a high-output cardiac state or heart failure may also lead to polyhydramnios, often associated with nonimmune hydrops fetalis (NIHF). Examples include sacrococcygeal teratoma, placental chorioangiomas, and other vascular (...) lesions; severe cardiac abnormalities, such as Ebstein anomaly or tetralogy of Fallot with absent pulmonary valve, cardiomyopathy, supraventricular tachycardia, and complete heart block; or fetal thyrotoxicosis. In addition, polyhydramnios may be caused by anomalies that cause fetal urine overproduction, such as ureteropelvic junction obstruction (termed “paradoxical” polyhydramnios). Small placental chorioangiomas are relatively common and rarely cause pregnancy complications, but large (≥5 cm

2019 Society for Maternal-Fetal Medicine

168. Syphilis in pregnancy

, transient accentuation of cutaneous lesions 47 , hypotension and tachycardia 38,40 · May precipitate uterine contractions (56–67%), decreased fetal movements (67%) and abnormal fetal heart rate (FHR) tracings (50%) 24 · In severely affected pregnancies preterm birth and stillbirth have been reported 24 Management · Do not delay treatment due to concerns about adequacy of monitoring · Offer information to women about JHR o Refer to Queensland Clinical Guideline Parent information · Advise women to: o (...) Abbreviations CSF Cerebrospinal fluid FHR Fetal heart rate GP General Practitioner HIV Human immunodeficiency virus IgM Immunoglobulin M IV Intravenous JHR Jarisch Herxheimer Reaction PCR Polymerase Chain Reaction POC Point of care QSSS Queensland Syphilis Surveillance Service SOP Standard operating procedure STI Sexually transmitted infection USS Ultrasound VDRL Venereal Diseases Research Laboratory Definition of terms Adequate treatment In a pregnant woman, treatment may be considered adequate if a stage

2019 Queensland Health

169. Primary postpartum haemorrhage

: abnormal CTG tracing, loss of fetal station · Postpartum presentation often associated with: o Pain, abdominal distension and persistent vaginal bleeding o Haematuria may occur if rupture extends into the bladder Treatment · Urgently transfer to OT · Confirm diagnosis (...) or · Hysterectomy (consider early) Unknown cause · Laparotomy – EUA Surgical procedures No Yes DRSABC (as relevant to circumstances) Assessment · Rate/volume of bleeding · Lie flat, oxygen 15 L/minute, keep warm · Continuous heart rate and SpO 2 , 15 minutely BP and temperature · Ensure routine third stage oxytocic given · 4Ts (tissue, tone, trauma, thrombin) Urgent bloods · FBC, Full chemistry profile (Chem20), coagulation profile, blood gas, · X-match if none current with laboratory · ROTEM® /TEG®

2019 Queensland Health

170. Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures

Director, Marie- Josée and Henry R. Kravis Center for Clinical Cardiovascular Health at Mount Sinai Heart; Director, Metabolic Support Divisions of Cardiology and Endocrinology, Diabetes, and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, New York; Past President, AACE and ACE 2 Guideline Task Force Co-Chair (TOS); Professor of Medicine and Director, Nutrition and Weight Management, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts 3 Guideline Task (...) ). Several guidelines for treatment of obesity have also been published as a resource for clinicians since 2013. Most notable are the American Heart Association (AHA)/American College of Cardiology (ACC)/The Obesity Society (TOS) Guideline for the Management of Overweight and Obesity in Adults (12), The American Society of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) Clinical Practice Guidelines for Comprehensive Care of Patients with Obesity (13), the Obesity Medicine

2019 American Association of Clinical Endocrinologists

172. Risk factors for breast cancer: A review of the evidence 2018

133 4.8.2 Cardiac glycosides 134 4.8.3 HPV 136 4.8.4 Hysterectomy 137 4.8.5 Pregnancy termination 139 4.8.6 Previous cancer other than breast cancer 140 4.8.7 Silicone breast implants 143 4.8.8 Stress 145 4.8.9 Trauma to the breast 147 4.8.10 Type 2 diabetes 148 4.9 Chemical exposures 150 4.9.1 Bisphenol A (BPA) 150 4.9.2 DDT exposure 151 4.9.3 Deodorant/antiperspirant 152 4.9.4 Dioxin 153 4.9.5 Ethylene oxide 155 4.9.6 Land contamination 156 4.9.7 Outdoor air pollution 158 4.9.8 Parabens 160 (...) and risk of breast cancer 393 Table D.53 Diet—processed meat and risk of breast cancer 395 Table D.54 Diet—red meat and risk of breast cancer 398 Table D.55 Environmental tobacco smoke and risk of breast cancer 401 Table D.56 Tobacco smoking and risk of breast cancer 405 Table D.57 Physical activity and risk of breast cancer 409 Table D.58 Shift work disrupting circadian rhythm and risk of breast cancer 415 Table D.59 Aspirin and risk of breast cancer 420 Table D.60 Cardiac glycosides and risk

2018 Cancer Australia

173. Canadian guidelines for controlled pediatric donation after circulatory determination of death-summary report Full Text available with Trip Pro

in these cases. Regarding GPS 36, in the past, when DCD was more commonly referred to as “donation after cardiac death,” authors argued that determining death by irreversible loss of cardiac function precluded DCD cardiac transplantation ( , ). However, our guidelines specifically define death as permanent loss of circulation in the donor. Whether the heart remains unresuscitated in the donor or is removed and resuscitated in another patient does not alter donor outcome: body and brain circulation remains (...) in cardiac pDCD: a) Cardiac transplant programs should establish criteria for acceptance of heart donation, ex vivo cardiac protocols, and heart allocation in pDCD, b) Consideration should be given to initiate cardiac pDCD program as either research protocols with research ethics board oversight or through programs that oversee innovative therapies. | Justification. Although there is minimal published experience with cardiac pDCD ( ), recent innovative reports of adult cardiac DCD using ex vivo heart

2017 CPG Infobase

174. Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada

. Prebtani MD, FRCPC, Vincent Woo MD, FRCPC S190 Management of Acute Coronary Syndromes Jean-Claude Tardif MD, FRCPC, FACC, FCAHS, Phillipe L. L'Allier MD, David H. Fitchett MD, FRCPCCONTENTS (continued): April 2018 Volume 42 Supplement 1 S196 Treatment of Diabetes in People With Heart Failure Kim A. Connelly MBBS, PhD, FCCS, Richard E. Gilbert MBBS, PhD, Peter Liu MD, FRCPC, FACC S201 Chronic Kidney Disease in Diabetes Philip McFarlane MD, PhD, FRCPC, David Cherney MD, PhD, FRCPC, Richard E. Gilbert (...) , ON Olivier F. Bertrand MD PhD Associate Professor of Medicine Quebec Heart–Lung Institute, Laval University, QC Acknowledgment / Can J Diabetes 42 (2018) A6–A16 Kim Connelly MBBS PhD Associate Professor Division of Cardiology, Department of Medicine, University of Toronto, Director, Krembil Stem Cell Facility, President, Canadian Society for Cardiac MRI, St. Michael’s Hospital, Toronto ON Michael Coons CPsych CBSM Clinical Health Psychologist Medical Bariatrics and Diabetes, St. Joseph’s Healthcare

2018 Diabetes Canada

175. Canadian immunization guide chapter on influenza and statement on seasonal influenza vaccine for 2017-2018

(traces) Gentamicin None Kanamycin Neomycin Kanamyci n Neomycin Neomycin None No Gentamicin None None Other clinically relevant non- medicinal ingredients* Egg protein, Chicken protein, Formalde- hyde, CTAB, Polysorbate 80 Egg protein, a-tocopheryl hydrogen succinate, Polysorbate 80, Formalde- hyde, Ethanol, Sodium deoxycholate, Sucrose Egg protein, Formalde- hyde, Polysorbate 80, CTAB Egg protein, Formalde- hyde,Poly- sorbate 80, CTAB Egg protein, Formalde- hyde, Triton X- 100 Egg protein, Formalde (...) ) France EK, McClure D, Hambidge S, et al. Impact of maternal influenza vaccination during pregnancy on the incidence of acute respiratory illness visits among infants. Arch Pediatr Adolesc Med. 2006;160(12):1277-83. (30) Steinhoff M, Omer S, Roy E, et al. Neonatal outcomes after influenza immunization during pregnancy: a randomized controlled trial. CMAJ. 2012;184(6):645-53. (31) Fell DB, Sprague AE, Liu N, et al. H1N1 influenza vaccination during pregnancy and fetal and neonatal outcomes. Am J Public

2017 CPG Infobase

176. Management Of Haemophilia

& Trauma Surgeon Gleneagles Hospital, Kuala Lumpur Associate Professor Dr. Azlan Husin Consultant Physician & Clinical Haematologist Hospital Universiti Sains Malaysia, Kelantan Dr. Carol Lim Kar Koong Head of Department & Consultant Obstetrician & Gynaecologist (Maternal Fetal Medicine) Hospital Sultan Ahmad Shah, Pahang Ms. Haironi Ismail Physiotherapist Hospital Putrajaya, Putrajaya Ms. Halimah Hashim Physiotherapist Hospital Raja Perempuan Zainab II, Kelantan Dr. Jalil Ishak Family Medicine (...) ): 20 mg/kg stat, then15 mg/kg every 4 - 6-hourly Max: 60 mg/kg (up to 90 mg/kg for 48 hours) Selective Cox-2 Inhibitors Celecoxib Adults (oral): 100 - 400 mg, 12 - 24-hourly Max: 800 mg/day Not recommended in severe renal and/or hepatic impairment Initiate therapy at lowest recommended dose in elderly Ischaemic heart disease Cerebrovascular disease Contraindicated in hypersensitivity to sulfonamides Associated with a lower risk of serious upper gastrointestinal side effects compared to NSAIDs

2018 Ministry of Health, Malaysia

178. The use of viscoelastic haemostatic assays in the management of major bleeding Full Text available with Trip Pro

management has been reported to improve overall clinical outcomes after cardiac surgery (Weber et al , ; Sartorius et al , ; Pearse et al , ; Trevisan et al , ), and result in less bleeding and lower need for re‐exploration after coronary artery bypass grafting (CABG) (Speiss et al , ). Duration of hospitalisation was also reduced (Ichikawa et al , ). Conversely, a recent systematic review of 15 randomised trials involving 8737 patients found no significant difference in mortality, reoperation (...) Online Library Terms and Conditions of Use. Shareable Link Use the link below to share a full-text version of this article with your friends and colleagues. Copy URL Share a link ) and 10% of cardiac surgery patients (Serraino & Murphy, ). Blood loss is one of the main causes of morbidity following liver transplantation (Gurusamy et al , ) and is one of the most common causes of death worldwide in women at the time of delivery (Say et al , ). Diagnosis of major bleeding is difficult and is often made

2018 British Committee for Standards in Haematology

179. Zika virus and safety of substances of human origin: a guide for preparedness activities in Europe ? first update

transmission through cells, tissues and organs remains unknown. Zika virus can also be transmitted vertically from an infected mother to the foetus during pregnancy and is responsible for foetal loss, microcephaly, and other congenital neurological syndromes [9]. The incubation period ranges from 3.5 days in a human volunteer [10] to 6 to 10 days in returning travellers and blood donors [3,11,12]. Although previous reports state that 80% of Zika virus infection cases are asymptomatic [13], it seems (...) -virus associated Guillain–Barré syndrome (GBS) have not been reported. Moreover, the likelihood of maternal and foetal exposure to blood products and presumably to other SoHO is very small. Data on Zika virus infection in donors of cells, tissues and organs and transmission of the virus to the transplant recipients are lacking. Nevertheless, the clear association between Zika virus infection and congenital malformations and GBS justifies the implementation of preventive measures to reduce the risk

2017 European Centre for Disease Prevention and Control - Technical Guidance

180. WHO recommendations: intrapartum care for a positive childbirth experience

for assessment of fetal well-being in healthy pregnant women undergoing spontaneous labour. Not recommended Intermittent fetal heart rate auscultation during labour 18. Intermittent auscultation of the fetal heart rate with either a Doppler ultrasound device or Pinard fetal stethoscope is recommended for healthy pregnant women in labour. Recommended Epidural analgesia for pain relief 19. Epidural analgesia is recommended for healthy pregnant women requesting pain relief during labour, depending on a woman’s (...) ), a cosponsored programme executed by the WHO. The views of the funding bodies have not influenced the content of this guideline. Editing: Green Ink, United Kingdom.vii ACRONYMS AND ABBREVIATIONS Acronyms and abbreviations ABO adverse birth outcome aOR adjusted odds ratio CERQual Confidence in the Evidence from Reviews of Qualitative research CI confidence interval cRCT cluster randomized controlled trial CTG cardiotocography DOI declaration of interest EB evidence base EtD evidence-to-decision FHR fetal

2018 World Health Organisation Guidelines

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